Parkland hospital board overturns CEO’s key hiring decision

1/1

Vernon Bryant/Staff Photographer

Parkland interim CEO Thomas Royer, seen at a Feb. 15 board meeting, called the situation involving John Beall "a regrettable distraction" that would not deter his office from addressing safety problems.

Parkland Memorial Hospital’s governing board overturned chief executive Dr. Thomas Royer’s hiring of a new senior leader charged with implementing patient-safety reforms after the CEO took action without approval of the board or federal safety monitors.

John Beall, a former hospital accreditation inspector and nursing executive with the Denton State Supported Living Center for the developmentally disabled, resigned Friday after only five days on the job as Parkland’s chief implementation officer. Earlier in the week, a news release quoted the interim CEO saying he was “absolutely thrilled to have John aboard as part of our senior leadership team.”

The position is considered crucial to carrying out a government-mandated plan to steer Parkland out of its crisis in patient care. Parkland must remedy hundreds of dangers, ranging from medication errors to infection control, found throughout the troubled hospital by Alvarez & Marsal Healthcare Industry Group, the monitoring team.

“This was a decision made without the approval of the board and A&M,” said Lauren McDonald, chairwoman of the Parkland board of managers. “We need to take a deeper dive into the applicant pool. We need someone with greater depth for this job.”

Royer declined to be interviewed, but he issued a statement Friday calling the situation “a regrettable distraction” that would not deter his office from addressing safety problems.

“We collectively came to the conclusion that Parkland would be better served by engaging a consulting expert in project management,” Royer said in the statement. “Beall informed me that this was not the position he desired, and some members of the board simultaneously expressed the view that, given this change, we should examine other applicants.”

Beall hung up the phone after The Dallas Morning News asked him for a comment Friday. Royer said that Beall will return to his inspector position at the Joint Commission, the nationwide accreditation organization for hospitals such as Parkland.

McDonald, who serves as spokeswoman for the governing board, declined to elaborate on the circumstances related to Beall’s hiring and departure. Other board members did not return phone calls from The News.

Tension and urgency

The hiring reversal is the latest sign of tension among government leaders overseeing reforms at the safety-net hospital.

Officials with Dallas County and the U.S. Centers for Medicare & Medicaid Services said the board’s move shows that it is committed to working closely with regulators to make Parkland safer. David Wright, deputy regional administrator for CMS, said it is “an expectation that Parkland consult with monitors on major decisions.”

Dallas County Judge Clay Jenkins, who along with four county commissioners approves Parkland’s board members and budget, said the hospital’s situation is so dire there is no room for missteps.

“It’s imperative that everyone at Parkland work with the monitors and regulators to turn around this hospital,” said Jenkins, adding that the monitors should always be “at the table leading the process.”

The county judge has criticized Royer’s actions in recent weeks. The chief executive has served three months of a six-month appointment, and it is unclear who will hold the job after the interim period is over.

Jenkins has faulted Royer’s frequent characterization of Parkland’s effort to correct compliance failures as a “journey to excellence.” He also has pressed the CEO to make public key portions of the monitors’ investigative report, which identified violations of more than 50 federal safety standards. Both Royer’s office and the board have withheld the report, citing a fear of lawsuits. And CMS is still reviewing the legality of releasing it.

The document, obtained by The News, describes failures in “nearly every aspect of the system.” The monitors found that infection control problems and breakdowns in emergency care have persisted since last summer when regulators discovered them, and faulted the hospital with unsanitary conditions throughout. It also documented more than100 medication errors and numerous breakdowns in staff accountability from the top down.

The analysis, conducted over three months, warns of problems so extensive and severe that leaders ofthe hospital must act fast to restructure the entire organization. It has until mid-2013 to prove it can sustain compliance with CMS regulations and retain hundreds of millions in federal funding it needs to operate.

That puts Parkland on an extremely tight timeline to overhaul its problems, because many hospitals, experts have said, require at least that much time to correct fewer and narrower issues.

Parkland must work collaboratively with regulators, safety monitors and other experts to stop this deepening crisis, Jenkins said.

“This urgency could be compared to going through a divorce, trying to figure out what to do with the kids, and at the same time figuring out how to keep your house from burning down,” the judge said.

Beall’s experience

Beall’s resume lists experience as chief nursing executive at the Denton living centerbetween November 2008 and June 2010. He was hired a month before the U.S. Justice Department released the findings of a broad investigation into the care of disabled residents at that school and 11 other state facilities. The December 2008 report said the institution violated the civil rights of residents through improper restraints and nursing failures — among the same problems that have persisted at Parkland.

Beall’sresume says he “worked with DOJ representatives to investigate and ultimately clear quality of care concerns.” A report issued last September by safety monitors overseeing care at the Denton facility found progress but said use of restraints remained out of compliance and nursing care needed more improvements.

Royer’s press release announcing Beall’s hire did not mention his stint at the Denton institution.

A spokeswoman for the Texas Department of Aging and Disability Services, which oversees the Denton facility, said it “had no issues or concerns regarding Mr. Beall’s job performance.” Beall, she said, “left the facility solely to take a position with another employer.”

To post a comment, log into your chosen social network and then add your comment below. Your comments are subject to our Terms of Service and the privacy policy and terms of service of your social network. If you do not want to comment with a social network, please consider writing a letter to the editor.

UT Southwestern Medical Center and Parkland Memorial Hospital are known for their contributions to medical research and public health. But have those accomplishments come at a cost to quality healthcare? The Dallas Morning News investigates patient safety and allegations of lax supervision of doctors in training at the public institutions.